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Confirming the structure of negative beliefs about psychosis and bipolar disorder: A confirmatory factor analysis study of the Personal Beliefs about Experience Questionnaire and Personal Beliefs about Illness Questionnaire
Author(s) -
Taylor Peter J.,
Pyle Melissa,
Schwannauer Matthias,
Hutton Paul,
Morrison Anthony
Publication year - 2015
Publication title -
british journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.479
H-Index - 92
eISSN - 2044-8260
pISSN - 0144-6657
DOI - 10.1111/bjc.12079
Subject(s) - psychology , clinical psychology , shame , confirmatory factor analysis , psychosis , bipolar disorder , psychiatry , schizophrenia (object oriented programming) , distress , test (biology) , structural equation modeling , cognition , social psychology , paleontology , statistics , mathematics , biology
Objectives Negative beliefs about psychosis and other mental health difficulties may contribute to depression and distress in individuals with these experiences. The Personal Beliefs about Experience Questionnaire ( PBEQ ) and Personal Beliefs about Illness Questionnaire ( PBI llQ) are two widely used measures of these beliefs. It is currently uncertain how the items on these measures map onto different underlying factors. This study therefore aimed to test the factor structure of these two measures. Methods Confirmatory factor analysis ( CFA ) was used to test three alternative, pre‐specified, factor structures for the PBI llQ and PBEQ in a sample of individuals diagnosed with bipolar disorder ( n = 202) and a sample of individuals with experien‐ces of psychosis ( n = 362). Associations with depressive symptoms were also examined. Result A three‐factor structure was supported for both measures, which included Negative Expectations/Appraisals ( NEA ), Internal Shame/Defectiveness ( ISD ) and External Shame ( ES ) factors. The NEA and ISD subscales also had consistent independent associations with depressive symptoms. Conclusions The results suggest that the PBI llQ and PBEQ may capture three distinct sets of negative beliefs in individuals with psychosis or bipolar disorder and that these beliefs may have important consequences for subsequent difficulties in these populations such as depression. Both measures may be helpful in supporting assessment and formulation in clinical practice and in evaluating belief change in intervention trials. However, when used in these settings, the three subscales identified in this study may be the most valid way of calculating scores on these measures. Practitioner points Negative personal beliefs about the causes, meaning and consequences of psychosis and bipolar disorder are associated with greater distress and depression. Two related measures, the PBI llQ and PBEQ , have been developed to assess these beliefs. Our analyses suggest that scores on these questionnaires are best broken down into three subscales which capture perceptions of internal shame or defectiveness, general negative appraisals and perceptions of external shame. These subscales may capture key underlying sets of negative beliefs within individuals with psychosis or bipolar disorder, which in turn impact upon well‐being, such as being associated with greater depression. These subscales can be used to aid assessment and formulation within clinical practice but may also provide a valuable means of assessing changes in negative beliefs following interventions.